I do believe I wrote that I thought that the night would go fairly easily; due to the large number of ambulances that would be on the road (Double time pay for today would mean that all overtime would be filled up completely).

Oh well, goes to show how wrong I can be.

We were out for most of the night, unable top catch even a ten minute nap and consequentially we were tired and prone to "Sense of humour failures". If there was one thing we needed last night it was a sense of humour.

The first job was to an elderly man who was found by his community carer laying on the floor covered in bloody vomit - the carer had put a duvet under the mans head, but hadn't tried to clean him up in any way. Instead we managed to clean him up a little in the back of the ambulance. He was quite ill and ended up in Resus.

Then we got into the type of job that characterised the rest of the night - a drunk male, surrounded by police who was adamant that he hadn't been assaulted (as we had been told) and who didn’t want anyone bothering him. This was fine by us as he was belligerent towards the police (who were just trying to help him) and us (who couldn't care less about him). The police were happy and told him to go home, but that wasn't good enough for him so he threw himself in front of the police car and lay down. Needless to say this didn't impress the police so they arrested him. Getting him into the back of the police van was funny to watch - especially when a very young copper ran over to tell us that "He looks like he is about to vomit", to which my reply was "Well stick his head out the van door then".
The police took him away, but we met up with him again at the London hospital after he feigned unconsciousness in the police cell. His saga ended with him sharing the "piss-head" bench outside the A&E with another four alcoholics.

We then got a "swollen throat", category “A”; which turned out to be a sore throat, with no airway obstruction, that the patient had been nursing since the morning. He sore throat also meant (for some reason I can't understand) that she couldn't walk in anything more than a shuffle. The walk from reception to the waiting room at Newham hospital took a couple of minutes.

Then we went to a 15 year old girl with a sore throat for two weeks that had called NHS (re) Direct they had then told her to call an ambulance!

Then we had the patient that I would have quite happily dropped out of the back of the ambulance while doing 70mph down the A13. We got a call from the police to a "fitting male". When we got there, the "fitter" was standing up, chatting to the police. The story was that he was an epileptic who during the night had got drunk, taken some cocaine - and when arrested (I don't know what for - but given the pub, quite probably affray) had had a fit. We walked him on to the ambulance and got halfway down the road where he proudly told us that he had faked his fit because he didn't want to be arrested - and instead had tickets to see West Ham in Cardiff. He then asked us if we could drop him off at his house.

I told him to "Fuck off out my ambulance" and kicked him out. To be honest he is lucky that is all that we did to him.

All during this Control were holding emergency calls all over London...We had over 3,700 calls yesterday.

With a bit of luck he'll be beaten up by Crystal Palace fans after the defeat of West Ham at the Cardiff Playoff.

The rest of the night continued in a similar vein, with our last job being an RTA on the A13 where a car drove into the back of another - the rear car driver had ran off, and the other driver didn't travel and was left in the care of the same police who dealt with our first drunk.

L.O.B. means "Load Of Bollocks", as in "This call is L.O.B". Last night was L.O.B.

I've been on a "Guidelines" course, essentially this is a course that tells us that we are already doing the right thing, and to introduce a new "book" with our treatment guidelines in in. It takes two days and tomorrow will include learning about child abuse (do we have to bring our own child?) So far the course has been a trainer telling us that this course changes nothing, and we are to continue doing what we are doing at the moment. At least the days are short, 8am 'til 2pm. At the start of every Powerpoint presentation is the same definition of "Clinical Governance".
We had to write our own scenarios - then swapped them around to other groups (this is a really easy teaching technique - you don't have to plan anything). There was also a chat about how our complaints to compliments ratio is about 50/50, and that most of the complaints are because of "staff attitude". So far I have had no complaints, and no compliments - I'm a strong believer of flying under the radar.

However there is a problem - the Guidelines book we should be getting is version 3.0, but the book we are actually getting is version 2.2.
The reason for this? Copyright. It seems that the London Ambulance Service wants to change a few bits to make it more relevant to London. But because the organization that wrote it maintains the copyright - it can't be changed for us. Lawrence Lessing's "Free culture" and the Suw Charman article I linked to on the 25th both state that you get value added when others can build on your work. This is a perfect example of this principle.
So the people of London are not getting the best clinical care because of copyright.

Clinical Governance is about getting the best care to the public, so it's a bit of a mixed message.

So...

You want to cross the street?

Can you see an ambulance with flashing blue lights coming towards you?

Then just ignore it!

We probably won't hit you

I took this video earlier today, hope you enjoy it and see what form of idiots we have walking the streets of Newham.

I woke up this morning to find out that Richard Biggs had died; for those of you who saw it, he played Dr Franklin in the TV series "Babylon 5". He was in his forties, married with three children, with the oldest being six years old. My sympathies go out to his family and friends.

Our complex is EIGHT ambulances short today, so it comes as no surprise that we are running around like the proverbial blue-arsed fly. Control keeps broadcasting jobs for which they have no ambulances, this means that a lot of crews are more unhappy than usual, as Control hassles us about "greening up" quicker. It doesn't bother me however, as if I'm busy doing jobs, it makes the shift go quicker.
As I'm typing this an ambulance has had a blow-out on the fast lane of the A102 - a very busy road. The crew are alright, but it means we are now nine ambulances down for the next two hours at least.
The jobs I've been doing are the usual Monday morning sort of stuff; 97 year old women having heart attacks, 10 year old boys with cut heads (a rather impressive 3 inch cut, mind you) and 88 year old men from nursing homes who have "high blood pressure" - they invariably have a better blood pressure than I do.

Now some silly sod has stabbed himself in the stomach with a pair of scissors.

I'm doing my overtime shift now, but unfortunately we are off the road at the moment, my ginger-bearded crewmate (not my normal crewmate) managed to reset the computer we have in the ambulance - this has caused an intense whining sound from the speakers, and more disturbingly a smell of electrical burning.

"We'd like to return to base please", we asked Control over the radio, "we can smell burnng".

"Are you sure it's safe", they replied.

"I hope so, we'll find out on the way", was my crewmates reply.

As of yet it hasn't burst into flames - but we parked it in the middle of the yard so that if it did decide to self-immolate it wouldn't damage the station building and it's very important tea-making facilities.

So now we are trying to find a spare motor, as the only other motor on station at the moment doesn't have any internal lights - which considering we are working at night - would make the shift "interesting" at least.

We have only done two jobs so far, and need an ambulance so we can go get some kebabs for our midnight snack, that and how can I torture drunks if I'm stuck on station?

I've gone back over the last month and have answered any questions that were put in the comments of postings. Remember, you can always get a quick answer off me if you email me. From some of the search terms that bring people here, I'd be more than happy to dispense my wisdom on those as well (If I know what I'm talking about).

I spoke to a copper from Limehouse today - they still haven't found the transit van with the Phosgene, that coupled with the 'attack' on the House of Commons yesterday seem to be reminding the Emergency (and 'essential') services that there is always the risk of trouble. Yet there hasn't been any information from the media, is this the "secrecy" that the Panorama programme was talking about?

If you want to know what is happening in Manchester with the Fire Service, you could do worse than to look here. Basically the FBU were made promises that have yet to be fulfilled.

Now time to relax and enjoy the fictional 24.

So damn tired...

I'm currently at that point where I wonder whether I am hungry enough to cook dinner before I go to sleep. Which biological urge will win out?

Today, our control wanted us to go to an emergency call when we were the other side of the Thames - I rather politely asked them if we were the nearest motor as we weren't actually a boat, the reply was, "Yes, do you have your water wings?". So we ended up going a couple of miles out of our way to cross the river.

The call was a faint, probably from the heat that is roasting London at the moment - at least the women are wearing revealing clothes, which makes our job of cruising through the street a bit more enjoyable.

Picked up two psychiatric drug-using patients in a row who were drunk and laying in the road perhaps 500 yards away from each other. Some children were poking the last one with a stick...

Then there was the 51 year old 4' 4" Asian grandmother who, upon seeing her husbands car being stolen jumped on the back and hung onto the rear windscreen wiper. She was flung off and thankfully not seriously hurt, mainly bruising and gravel rash. Unfortunately the car that was stolen including her house keys and bank books. The A&E was so busy they had to put her out in the waiting room - something that annoyed me no end, especially as the nurse that did it had already annoyed me by suggesting that I didn't know what the symptoms of Bulimia were.

Now to eat/sleep - then lather/rinse/repeat tomorrow.

A van carrying Phosgene and Methyl Bromide was stolen today from Bow.

Phosgene, for those of you who don't know, is a poisonous gas which was used in the trenches of World War I - hideously fatal to humans. Methyl Bromide is an insecticide - and is not much fun to be around either. Why was a van carrying, for want of a better term, chemical weapons left unguarded? Was it stolen to order? Why hasn't the government mentioned this - why isn't it on every news programme in the country?
This is the secret knowledge of the ambulance service...Does it make you sleep soundly in your bed knowing that this stuff happens and you never know about it?

If you smell a mossy/cut grass smell then go upwind and await the emergency services in their "noddy suits".